by Jane Anderson
Premera Blue Cross has broadened its partnership with predictive
health care analytics startup Cardinal Analytx Solutions with a view toward
identifying why certain individuals have extreme escalations in medical
treatment.
Cardinal Analytx's
machine learning models "can predict members with near-term care needs,
accurately and consistently over time," says Colt Courtright, director of
corporate data and analytics at Premera. He adds that the Blues plan has found
these members are willing to engage in care management support. This indicates
the program both will help members and eventually show a population-level
return on investment, he says.
Premera and Cardinal are
exploring whether to provide primary care physicians with the information, says
Nigam Shah, M.D., who founded Cardinal Analytx with lead investor Cardinal
Partners. Ultimately, "we want to use AI to improve a patient's health
trajectory, empower the PCP with more information, and remove clinical and
financial burdens on the patient," Courtright says.
At BlueCross BlueShield
of Western New York and BlueShield of Northeastern New York, data teams now are
able to identify members who are pre-diabetic through predictive analytics, and
then engage them to ensure a proper care plan is in place, says Adam Dunning,
director of health care economics for the New York Blues plans.
Meanwhile, Health Care
Service Corp. has focused on analytics for providers "to make it easier
for providers to gain insight into their quality of care and close care
gaps," according to Gary Stanford, vice president and actuary, HCSC
provider network analytics.
From
Health Plan Weekly
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